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肺动脉导管插入术期间产生多种室性心律失常的因素分析。

An analysis of the factors producing multiple ventricular arrhythmias during pulmonary artery catheterization.

作者信息

Satoh Hajime, Miyata Yuka, Hayasaka Tomohiko, Wada Tsutomu, Hayashi Yukio

机构信息

Department of Anaesthesia Service, Sakurabashi-Watanabe Hospital, Osaka, Japan.

出版信息

Ann Card Anaesth. 2017 Apr-Jun;20(2):141-144. doi: 10.4103/aca.ACA_18_17.

Abstract

BACKGROUND

The development of arrhythmias during placement of a pulmonary artery catheter (PAC) is common.

AIMS

This study was designed to examine factors influencing development of ventricular arrhythmias in adult patients undergoing cardiovascular operations during the catheter placement.

SETTINGS AND DESIGNS

Prospective, observational, cohort study.

METHODS

We prospectively studied 174 patients undergoing cardiovascular operations. A PAC was inserted through the right internal jugular vein by staff anesthesiologists. Electrocardiography tracings were recorded as the catheter was advanced from the right atrium to the pulmonary artery. Arrhythmias were classified as absent, single, or multiple (two or more consecutive) ventricular arrhythmias. We examined risk factors to produce ventricular arrhythmias during the placement.

STATISTICAL ANALYSIS

The data were analyzed using logistic regression analysis to assess factors for the occurrence of ventricular arrhythmias after univariate analyses.

RESULTS

Ventricular arrhythmias (single and multiple) occurred in 149 patients (85.6%) and multiple arrhythmias were observed in 78 patients (44.8%). There were no factors to facilitate the ventricular arrhythmias (single and multiple), whereas it showed that valvular diseases (P = 0.049) and the placement time (P < 0.001) are significant factors to produce multiple arrhythmias.

CONCLUSION

Both valvular diseases and long placement time were significant risk factors to produce multiple ventricular arrhythmias during placement of a PAC.

摘要

背景

在放置肺动脉导管(PAC)期间心律失常的发生很常见。

目的

本研究旨在探讨影响成年心血管手术患者在导管放置过程中发生室性心律失常的因素。

设置与设计

前瞻性、观察性队列研究。

方法

我们前瞻性地研究了174例接受心血管手术的患者。由麻醉科医生通过右颈内静脉插入肺动脉导管。当导管从右心房推进到肺动脉时记录心电图。心律失常分为无、单发或多发(连续两个或更多)室性心律失常。我们检查了放置过程中产生室性心律失常的危险因素。

统计分析

在单因素分析后,使用逻辑回归分析评估室性心律失常发生的因素。

结果

149例患者(85.6%)发生了室性心律失常(单发和多发),78例患者(44.8%)观察到多发心律失常。没有促进室性心律失常(单发和多发)的因素,而瓣膜疾病(P = 0.049)和放置时间(P < 0.001)是产生多发心律失常的重要因素。

结论

瓣膜疾病和较长的放置时间都是在放置肺动脉导管期间产生多个室性心律失常的重要危险因素。

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